The Journal of clinical psychiatry
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Conversion disorder is a somatoform disorder defined by the presence of pseudoneurologic symptoms relating to voluntary sensory or motor function. The correct diagnosis of conversion disorder presenting with motor symptoms is complicated by the lack of gold-standard diagnostic tests and the absence of a universally accepted set of positive diagnostic criteria. This article reviews the epidemiology, pathophysiology, presentation, differential diagnosis, treatment, and prognosis of motor conversion, placing emphasis on diagnostic validity, reliability, and utility, while evaluating the empirical evidence supporting diagnostic and treatment strategies. ⋯ Advances in neuropsychiatric research are leading to significant improvements in the diagnosis and understanding of motor conversion disorders. Positive, objective, and quantitative diagnostic criteria show significant promise for enhancing diagnostic accuracy. Current pathophysiologic research has begun to provide mechanistic explanations for conversion symptoms, thus blurring the distinction between psychogenic and organic motor disorders.
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The goal of this study was to examine the associations between specific anxiety disorders and the risk of major depressive disorder and to explore the role of various clinical characteristics of anxiety disorders in these relationships using a prospective, longitudinal design. ⋯ Our findings suggest that anxiety disorders are risk factors for the first onset of major depressive disorder. Although a number of clinical characteristics of anxiety disorders appear to play a role in the association between anxiety disorders and depression, severe impairment is the strongest predictor of major depressive disorder.
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Comment Letter Comparative Study
Acetaminophen preferable to ibuprofen for pretreatment of electroconvulsive therapy-induced headache.
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Comparative Study Clinical Trial
Risperidone in the treatment of delirium: results from a prospective open-label trial.
Effective treatment is necessary to reverse delirium and prevent potentially serious consequences. ⋯ Low-dose risperidone can improve cognitive and behavioral symptoms of delirium in medically ill patients.
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Anticonvulsants that act as ligands at alpha(2)delta subunits of voltage-gated calcium channels are proving to be novel treatments for chronic pain.